2021
Associations Between Health Literacy and End-of-Life Care Intensity Among Medicare Beneficiaries
Luo Q, Shi K, Hung P, Wang SY. Associations Between Health Literacy and End-of-Life Care Intensity Among Medicare Beneficiaries. American Journal Of Hospice And Palliative Medicine® 2021, 38: 626-633. PMID: 33472379, DOI: 10.1177/1049909120988506.Peer-Reviewed Original ResearchConceptsAggressive EOL careLow health literacyEOL careHealth literacyMedicare beneficiariesHospital deathCare intensityHigher oddsEOL care intensityLife care intensityPatient-provider communicationProportion of decedentsMonths of lifeDays of lifeHospice enrollmentHL scoreMultivariable analysisHospice useCare measuresRetrospective analysisLife careMedicare feeService decedentsDecedentsCareTrend of Non-contrast Chest Computed Tomography Use in the Lung Cancer Screening Era: SEER-Medicare 2008–2016
Yang SC, Gross C, Wang JD, Wang SY. Trend of Non-contrast Chest Computed Tomography Use in the Lung Cancer Screening Era: SEER-Medicare 2008–2016. Journal Of General Internal Medicine 2021, 36: 3589-3591. PMID: 33469753, PMCID: PMC8606484, DOI: 10.1007/s11606-020-06586-4.Peer-Reviewed Original ResearchEnd-of-life patterns of symptom management and cancer-directed care among Medicare beneficiaries with lung cancer: a claims-based analysis
Davidoff AJ, Canavan ME, Prsic E, Saphire M, Wang SY, Presley CJ. End-of-life patterns of symptom management and cancer-directed care among Medicare beneficiaries with lung cancer: a claims-based analysis. Supportive Care In Cancer 2021, 29: 3921-3932. PMID: 33389087, DOI: 10.1007/s00520-020-05964-2.Peer-Reviewed Original ResearchMeSH KeywordsAgedFemaleHumansLung NeoplasmsMaleMedicareRetrospective StudiesTerminal CareUnited StatesConceptsCancer-directed therapySymptom management servicesLung cancerMedicare beneficiariesCare contentYounger ageEarlier hospice enrollmentLife care patternsLung cancer decedentsPercentage of patientsClaims-based analysisMethodsThis retrospective studyMost Medicare beneficiariesNonhospice settingsCancer decedentsUsual careHospice enrollmentSymptom managementRetrospective studyMedicare databaseSkilled nursingHigh comorbidityCare intensityMedicare claimsMultinomial logistic regression
2020
Geographic Variations of Potentially Curative Treatments for Hepatocellular Carcinoma in the United States: A SEER-Medicare Study.
Cheng E, Hung P, Wang SY. Geographic Variations of Potentially Curative Treatments for Hepatocellular Carcinoma in the United States: A SEER-Medicare Study. Journal Of The National Comprehensive Cancer Network 2020, 18: 729-736. PMID: 32502978, DOI: 10.6004/jnccn.2020.7529.Peer-Reviewed Original ResearchConceptsHospital referral regionsCurative treatmentHepatocellular carcinomaIncidence of HCCCox proportional hazards modelSEER-Medicare studyPercutaneous ethanol injectionHepatitis B virusProportional hazards modelMore comorbiditiesSurgical resectionSurvival benefitTreatment patternsSEER-MedicareB virusRadiofrequency ablationEthanol injectionTreatment utilizationReferral regionsBetter survivalLower riskHazards modelPatientsSurvivalTreatmentAssociations Between End-of-Life Expenditures and Hospice Stay Length Vary by Clinical Condition and Expenditure Duration
Hung P, Hsu SH, Wang SY. Associations Between End-of-Life Expenditures and Hospice Stay Length Vary by Clinical Condition and Expenditure Duration. Value In Health 2020, 23: 697-704. PMID: 32540226, DOI: 10.1016/j.jval.2020.01.021.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseCongestive heart failureEOL expendituresHospice staysEnd Results-Medicare dataLonger hospice staysObstructive pulmonary diseaseMonths of lifeDays of lifeDistinct disease trajectoriesPatient disease groupsCancer decedentsDifferential associationsHeart failureAggressive endPulmonary diseaseHospice lengthMedical covariatesCancer patientsHospice useDisease groupClinical conditionsLife careDisease trajectoriesPatientsSevere functional limitation due to pain & emotional distress and subsequent receipt of prescription medications among older adults with cancer
Presley CJ, Canavan M, Wang SY, Feder SL, Kapo J, Saphire ML, Sheinfeld E, Kent EE, Davidoff AJ. Severe functional limitation due to pain & emotional distress and subsequent receipt of prescription medications among older adults with cancer. Journal Of Geriatric Oncology 2020, 11: 960-968. PMID: 32169548, PMCID: PMC7346676, DOI: 10.1016/j.jgo.2020.02.006.Peer-Reviewed Original ResearchConceptsSevere functional limitationsCo-occurring symptomsFunctional limitationsOlder adultsPrescription medicationsEmotional distressOlder adult Medicare beneficiariesAdult Medicare beneficiariesPrescription claims dataStage IV diseaseSupportive care needsMultivariable logistic regressionPrescription medication useMedicare Part D enrollmentPart D enrollmentCertain cancer typesMedication useLung cancerClaims dataPainMedicare beneficiariesCare needsFunctional independenceParticipant characteristicsCancer
2019
Factors Associated With Hospices’ Nonparticipation in Medicare’s Hospice Compare Public Reporting Program
Hsu SH, Hung P, Wang SY. Factors Associated With Hospices’ Nonparticipation in Medicare’s Hospice Compare Public Reporting Program. Medical Care 2019, 57: 28-35. PMID: 30489545, DOI: 10.1097/mlr.0000000000001016.Peer-Reviewed Original ResearchMeSH KeywordsCommunity-Institutional RelationsData CollectionHospicesHumansMedicareOwnershipUnited StatesConceptsArea Health Resource FileMultivariate logistic regressionNurse staffing ratiosPublic reporting programsQuality Reporting ProgramReporting ProgramHospice quality reporting programParticipation ratesPatient daysInpatient careHospice careProfit hospicesStaffing ratiosHospiceLogistic regressionMedicaid ServicesResource FileLow participation ratesService filesHealthcare Cost Report Information SystemCareNonparticipantsNonparticipationQuality measuresFurther research
2018
Associations of preoperative breast magnetic resonance imaging with subsequent mastectomy and breast cancer mortality
Wang SY, Long JB, Killelea BK, Evans SB, Roberts KB, Silber AL, Davidoff AJ, Sedghi T, Gross CP. Associations of preoperative breast magnetic resonance imaging with subsequent mastectomy and breast cancer mortality. Breast Cancer Research And Treatment 2018, 172: 453-461. PMID: 30099634, PMCID: PMC6193824, DOI: 10.1007/s10549-018-4919-3.Peer-Reviewed Original ResearchConceptsBreast-conserving surgeryBreast cancer mortalitySubsequent mastectomyCancer mortalityPre-operative MRIBreast cancerSubgroup analysisStage I/II breast cancerEnd Results-Medicare datasetPreoperative breast magnetic resonanceEarly-stage breast cancerMagnetic resonance imaging useReceipt of radiotherapyBreast magnetic resonanceClinical outcomesCox regressionResultsOur sampleImproved outcomesAdjusted ratesMRI useOlder womenLower riskMastectomyImaging useRadiotherapy
2017
Associations of Hospice Disenrollment and Hospitalization With Continuous Home Care Provision
Wang SY, Dang W, Aldridge MD, Canavan M, Cherlin E, Bradley E. Associations of Hospice Disenrollment and Hospitalization With Continuous Home Care Provision. Medical Care 2017, 55: 848-855. PMID: 28692573, PMCID: PMC5554087, DOI: 10.1097/mlr.0000000000000776.Peer-Reviewed Original ResearchLonger Periods Of Hospice Service Associated With Lower End-Of-Life Spending In Regions With High Expenditures
Wang S, Hsu SH, Huang S, Soulos PR, Gross CP. Longer Periods Of Hospice Service Associated With Lower End-Of-Life Spending In Regions With High Expenditures. Health Affairs 2017, 36: 328-336. PMID: 28167723, PMCID: PMC5972542, DOI: 10.1377/hlthaff.2016.0683.Peer-Reviewed Original Research
2016
Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment
Wang SY, Aldridge MD, Canavan M, Cherlin E, Bradley E. Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment. Journal Of Pain And Symptom Management 2016, 52: 813-821. PMID: 27697564, PMCID: PMC5154927, DOI: 10.1016/j.jpainsymman.2016.05.031.Peer-Reviewed Original ResearchConceptsHospice disenrollmentHospice enrollmentPatient characteristicsContinuous home careCHC utilizationMinority of patientsHome careMore comorbiditiesMultivariable analysisMultivariable modelHospice carePatientsHospitalizationService MedicareHospice agenciesHospiceDisenrollmentExpensive careStudy periodCareEnrollmentAssociationComorbiditiesCancerAssociations Between End-of-Life Cancer Care Patterns and Medicare Expenditures.
Wang SY, Hall J, Pollack CE, Adelson K, Davidoff AJ, Long JB, Gross CP. Associations Between End-of-Life Cancer Care Patterns and Medicare Expenditures. Journal Of The National Comprehensive Cancer Network 2016, 14: 1001-8. PMID: 27496116, PMCID: PMC5577560, DOI: 10.6004/jnccn.2016.0107.Peer-Reviewed Original ResearchConceptsDay of deathLife care expendituresLife careIntensive endCancer decedentsIntensive care unit admissionCare expendituresLife care interventionsCare unit admissionEmergency department visitsSEER-Medicare databaseLast monthProportion of decedentsHospital referral regionsExpenditure differencesHospital deathICU admissionUnit admissionDepartment visitsHospice enrollmentIntensive careHighest quintileLater chemotherapyHospice useLowest quintileEnd-of-Life Care Intensity and Hospice Use
Wang SY, Aldridge MD, Gross CP, Canavan M, Cherlin E, Johnson-Hurzeler R, Bradley E. End-of-Life Care Intensity and Hospice Use. Medical Care 2016, 54: 672-678. PMID: 27111747, PMCID: PMC4907842, DOI: 10.1097/mlr.0000000000000547.Peer-Reviewed Original ResearchConceptsLife care intensityHospital referral regionsShort hospice enrollmentEmergency department useCare intensityHospice useHospice enrollmentDepartment useLife careIntensive care unit admissionOverall hospice useCare unit admissionProportion of decedentsMonths of lifeUnit admissionICU admissionICU daysPatient characteristicsIntensive careLowest quintileReferral regionsIntensive endShort stayAORNumber of daysTransitions Between Healthcare Settings of Hospice Enrollees at the End of Life
Wang SY, Aldridge MD, Gross CP, Canavan M, Cherlin E, Johnson-Hurzeler R, Bradley E. Transitions Between Healthcare Settings of Hospice Enrollees at the End of Life. Journal Of The American Geriatrics Society 2016, 64: 314-322. PMID: 26889841, PMCID: PMC4762182, DOI: 10.1111/jgs.13939.Peer-Reviewed Original ResearchConceptsMonths of lifeSkilled nursing facilitiesHospice enrollmentHealthcare settingsNursing facilitiesHospice usersHospital-based palliative careRetrospective cohort studyHome health agenciesEnd of lifeCohort studyPalliative careCare transitionsHospice enrolleesHealthcare transitionHigher oddsClaims dataHospice decedentsMedicare beneficiariesHospice programsHospiceHealth agenciesCareNotable proportionDecedentsTrends in end-of-life cancer care in the Medicare program
Wang SY, Hall J, Pollack CE, Adelson K, Bradley EH, Long JB, Gross CP. Trends in end-of-life cancer care in the Medicare program. Journal Of Geriatric Oncology 2016, 7: 116-125. PMID: 26783015, PMCID: PMC5577563, DOI: 10.1016/j.jgo.2015.11.007.Peer-Reviewed Original ResearchConceptsLife cancer careDay of deathAggressive endLife careCancer careHospital deathHospice enrollmentEmergency departmentIntensive care unit admissionEnd Results-Medicare dataAggressiveness of endLate hospice enrollmentLife chemotherapy useCare unit admissionHospital referral regionsResult of cancerProportion of beneficiariesChemotherapy useICU admissionUnit admissionED visitsPatient demographicsTumor characteristicsReferral regionsMedicare beneficiaries
2015
Geographic Variation of Hospice Use Patterns at the End of Life
Wang SY, Aldridge MD, Gross CP, Canavan M, Cherlin E, Johnson-Hurzeler R, Bradley E. Geographic Variation of Hospice Use Patterns at the End of Life. Journal Of Palliative Medicine 2015, 18: 771-780. PMID: 26172615, PMCID: PMC4696438, DOI: 10.1089/jpm.2014.0425.Peer-Reviewed Original ResearchThe Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer
Xu X, Herrin J, Soulos PR, Saraf A, Roberts KB, Killelea BK, Wang SY, Long JB, Wang R, Ma X, Gross CP. The Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer. Health Services Research 2015, 51: 167-186. PMID: 26119176, PMCID: PMC4722219, DOI: 10.1111/1475-6773.12328.Peer-Reviewed Original ResearchConceptsBreast cancer careHospital referral regionsCancer careMedicare expendituresBreast cancerRadiation therapyTreatment factorsMean Medicare expendituresEnd Results-MedicareSpecific treatment modalitiesContribution of patientCost of careHighest spending quintilePatient factorsTreatment patternsTumor characteristicsCancer characteristicsTreatment modalitiesReferral regionsMedicare beneficiariesQuintilePatientsCancerCareTherapy
2014
Understanding Regional Variation in Medicare Expenditures for Initial Episodes of Prostate Cancer Care
Wang SY, Wang R, Yu JB, Ma X, Xu X, Kim SP, Soulos PR, Saraf A, Gross CP. Understanding Regional Variation in Medicare Expenditures for Initial Episodes of Prostate Cancer Care. Medical Care 2014, 52: 680-687. PMID: 25023913, PMCID: PMC4129645, DOI: 10.1097/mlr.0000000000000158.Peer-Reviewed Original ResearchConceptsAncillary proceduresPatient characteristicsTreatment modalitiesTreatment intensityEnd Results-Medicare databaseProstate cancer careSpecific treatment modalitiesContribution of patientHospital referral regionsInitial treatmentCancer careInitial episodeNoncancer controlsProstate cancerQuintile 5Referral regionsSubstantial geographic variationCare costsMedicare expendituresCostly modalityTreatment factorsMean expenditureLowest expenditure quintileSurgeryModalitiesExamining the Cost-Effectiveness of Radiation Therapy Among Older Women With Favorable-Risk Breast Cancer
Sen S, Wang SY, Soulos PR, Frick KD, Long JB, Roberts KB, Yu JB, Evans SB, Chagpar AB, Gross CP. Examining the Cost-Effectiveness of Radiation Therapy Among Older Women With Favorable-Risk Breast Cancer. Journal Of The National Cancer Institute 2014, 106: dju008. PMID: 24598714, PMCID: PMC3982782, DOI: 10.1093/jnci/dju008.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrachytherapyBreast NeoplasmsComorbidityCost-Benefit AnalysisFemaleHealth ExpendituresHumansLife ExpectancyMedicareNeoplasm Recurrence, LocalNeoplasm StagingQuality of LifeQuality-Adjusted Life YearsRadiotherapy, Intensity-ModulatedRisk AssessmentRisk FactorsSampling StudiesSEER ProgramUnited StatesConceptsExternal beam radiation therapyIncremental cost-effectiveness ratioQuality-adjusted life yearsBreast cancerOlder womenRadiation therapyEnd Results-Medicare databaseRisk breast cancerBeam radiation therapyCost-effectiveness ratioNewer radiation therapy modalitiesQuality of lifeRadiation therapy modalitiesLocal recurrenceTrial criteriaRT modalityTherapy modalitiesLife yearsCancerIncremental costTherapyWomenBaseline stateNew modality